Child Abuse Prevention

Practicing Safety: A Child Abuse and Neglect Prevention Project

The general pediatrician is in a prime position to play a much-expanded role in the primary and secondary prevention of child abuse and neglect. Anticipatory guidance is a regular part of pediatric care providing the context for teaching child abuse and neglect/violence prevention, parenting skills and identifying and supporting vulnerable families. For this reason, the AAP, with the generous support from the Doris Duke Charitable Foundation, launched the first phase of Practicing Safety in January 2003 and the second phase in 2007 in an effort to decrease child abuse and neglect by enhancing anticipatory guidance and increasing screening provided by pediatric practices to families of children ages 0-3. Visit the Practicing Safety Web site for more information about the project, including patient and practice tools used.

Abusive Head Trauma/Shaken Baby Syndrome Prevention

Disclaimer: The information below is selected for its value and relation to child abuse prevention and does not represent an endorsement or an official opinion or position of the American Academy of Pediatrics.

For years the assumption had been that if your baby cried excessively they had “colic,” leading parents and caregivers to believe that there was something wrong or abnormal with their baby. However, over 40 years of research on early infant crying has led to the understanding that, in addition to infants with a specific illness, there is an early period of increased and then decreased crying starting at about two weeks and lasting until the third or fourth month of life. This crying is completely normal and unrelated to infants having a disease or physical problem or parents having different care giving styles. This crying is not an indication that there is something wrong with the baby, but rather a normal behavioral developmental stage that all babies have.

The Period of PURPLE Crying program provides a new way to help parents understand this period in their baby’s life. The acronym PURPLE is used to describe specific characteristics of an infant’s crying. It lets parents and caregivers know that what they are experiencing is normal and, although frustrating, is a phase in their child’s development.

Peak of Crying – Crying peaks during the second month, decreasing after that
Unexpected – Crying comes and goes unexpectedly, for no apparent reason
Resists Soothing – Crying continues despite all soothing efforts by caregivers
Pain-like Face – Infants look like they are in pain, even when they are not
Long Lasting – Crying can go on for 30-40 minutes at a time, and often for much longer
E
vening Crying – Crying occurs more in the late afternoon and evening

The word period is important because it tells parents that it is only temporary and will come to and end.  

The program also includes research-based, practical strategies to guide how to soothe their infants and to cope with unsoothable crying.

To learn more about the Period of PURPLE Crying as well as other child development topics visit: 

What is the Period of PURPLE Crying Program?

www.PURPLEcrying.info

Sexual Violence Prevention

Sexual violence is a sex act completed or attempted against a person's will or against a person unable to consent because of age-appropriate cognitive ability, illness, disability, or the influence of alcohol or other drugs.  Pediatricians and other healthcare professionals are in a prime position to play a much expanded role in the primary prevention of sexual violence.

Since sexual violence occurs within a complex framework of family factors, peer interactions, adult-child relationships, and child characteristics, effective primary prevention in a practice must involve the parent, the healthcare professional and the child in different ways at different times during childhood and adolescence. In September 2005, the AAP received a cooperative agreement grant from the Centers for Disease Control and Prevention (CDC) to support the pediatrician and other healthcare professionals in this role.  As a result, the AAP has developed an educational toolkit to provide information, guidance and tools to prevent sexual violence in the office and the community.  The CD-ROM version features 4 practical video case vignettes showing healthcare professionals how to talk to patients and parents about sexual violence assessment and prevention. The AAP designates the CD-ROM version as an educational activity for a maximum of 3 AMA PRA Category 1 CreditsTM.  It can be purchased by visiting the AAP Bookstore. The Web version contains the majority of the content, including the written scripts for the videos, and can be viewed by clicking here.

Another activity of the grant was to conduct a needs assessment, which was done via an AAP Periodic Survey of Fellows. PS #68 was fielded March through July 2007 and is summarized here.